Should a society provide support from general funding (e.g., income tax) to individuals whose actions lead directly (and possibly predictably) to their distress; e.g., medical care for heavy smokers who suffer smoking related illness, air-sea rescue for recreational ocean-going sailors, financial support to people who are not willing to fully support themselves. Some of these examples are complex and contentious; but, what is fair and how can we administer a fair system?

Where survival, basic health, or dignity are at stake, personsshould be entitled to society's support. In first approximation, a fairsystem of such support might be one that is funded out of revenuesraised from those who might call on it. For example, tobacco users areentitled to any additional essential medical care they may need as aresult of their habit, and the cost of such additional care is fundedout of tobacco taxes.

Some may object to this system that itunduly restricts their liberty. They prefer not to fund the support andnot to receive it should they need it. These objectors fall into twogroups: Some want the support but pay for it as needed. The others want to forgo the support altogether.

Insome cases it would make sense, ideally, to exempt people in the firstgroup. Thus consider some of your recreational ocean-going sailors, for example, who do not want to contribute to marine rescues of people theyconsider irresponsible amateurs. Each of them gives society somefinancial guarantee that she will pay the full cost of any rescue shemay need herself. Cumbersomeness aside, why not exempt such people from anyrescue tax on ocean-going vessels?

Considernext those willing toforgo support or rescue in exchange for saving the tax. I think societyshould generally refuse this exchange. For one thing, it may beimpractical -- to ensure that everyone on board anuntaxed boat is a competent adult who has signed the waiver, forexample, or to decide quickly whether a particular heart attack is dueto smoking or not. Moreimportantly, it is morally odious to ask our coast guard to stand by aspeople are drowning or to ask our emergency-room doctors to leave someserious tobacco-related health problemsuntreated.

Thesesame moral reasons are decisive in cases where those needing support orrescue did not and cannot contribute. Our society should pay for itscoast guard to rescue sailors and for its doctors to treat smokers evenif those in trouble have not contributed to its tax revenuesand cannot pay for the service. This is a duty of decency, notfairness, that any moderately affluent society should discharge, out of general tax revenues, toward indigentforeigners, for example, and toward its own citizens who areunable orunwilling to earn their own living. This includes all children, of course,and all mentally or physically disabled. And it even includesable-bodied and competent adults who refuse allemployment. They too should nonetheless have access to basic food,water, clothing,medical care, shelter, and public toilets.